'Mem, mem, mem': after a stroke, a prolific novelist struggles to say how the mental world of aphasia looks and feels.

Author:West, Paul

Paul West - Excerpt


One day in June of 2003, my husband, Paul West, lay in a hospital room in Ithaca, New York, watching the sun's hallelujahs beyond the sealed window and aching to go home. He'd already been there for three weeks with a kidney infection that became systemic, one of those rootin'-tootin' staph bugs older than sharks or ginkgo trees, and I'd camped out with him, lest he trip over several leashes and the two lines dripping fluids into or out of him. Struggling from bed, he made his way to the bathroom. The next morning he would be heading home at last.

A few moments later he walked back out and stood at the foot of the bed, eyes glazed, his face like fallen ice. Paul had had a massive stroke, one tailored to his own private hell. The author of more than 50 stylishly written books, a master of English prose with the largest working vocabulary I'd ever encountered, a man whose life revolved around words, he had suffered brain damage to the key language areas of his brain and could no longer process language in any form. Global aphasia, it's called--the curse of a perpetual tip-of-the-tongue memory hunt. He understood little of what people said, and all he could utter was the syllable "mem." Nothing more.

Many doctors, tests, and frantic days followed, and his prognosis was grim. The brain cells were dead in Broca's area and some of Wernicke's area, he could no longer swallow food without choking, and, worst of all, it was a left hemisphere stroke. I'd just published a poetics of the brain, and I knew that the left hemisphere processes positive feelings, the right negative ones; unopposed, the remaining right hemisphere could spark dark angry emotions for the rest of his life.

But Paul had a couple of important traits going for him. Because he had word-smithed for seven decades, he had forged dense thickets of brain connections for language. Also, he could be diabolically determined.

After three weeks in the hospital's rehab unit, he was able one day to say proudly: "I can talk good coffee," but little more. Still, it was a complete sentence. I took him home, hired speech therapists, who, alas, weren't able to help him move beyond simple utterances. Whenever he spoke, the wrong names for things tumbled out. Aphasia is, above all, a sorting disorder. And, with short-term memory clobbered, by the time he got to the second half of a sentence he had forgotten the first half.

"You know, dear," I said to him one day, about two months after the stroke, when he was feeling mighty low, "maybe you want to write the first aphasic memoir." He smiled broadly, said, "Good idea! Mem, mem, mem." And so he began dictating, sometimes with mountain-moving effort, and at others sailing along at a good clip, an account of what he'd just gone through, what the mental world of aphasia felt and looked like. Writing the book was the best speech therapy anyone could have prescribed. For three exhausting hours each day, he forced his brain to recruit cells, build new connections, find the right sounds to go with words, and piece together whole sentences. Going over the text the next day helped refine his thoughts and showed him some of aphasia's fingerprints in the prose.

Now, three years later, he has just finished writing his first novel since the stroke, one with Westian characters and themes. During a three-hour window of heightened fluency in the middle of the day, he can write in longhand, make phone calls, lunch with friends. He has reloomed vibrant carpets of vocabulary, and happily, despite the left hemisphere stroke, he seems happier than before, and I think his life feels richer in a score of ways.

What follows is an excerpt from The Shadow Factory, the aphasic memoir Paul dictated with such struggle and resolve, "forcing language back on itself." In it, he recalls life in the hospital's rehab unit, what he felt and thought, and explores some of the all-too-real tricks the mind plays to save itself from the tomb of lost words.



The difference between my own refracted gaze of the world and Diane's is that she sees the world in all its detail, squirming into the needlepoint alleyways that leopards reject, and mine is to look on the offered scene as a species of broadcloth identified mainly through its ribbons and Tam-o'-Shanters. This sharing the load usually means that between us we cover the waterfront, missing a few mouse holes and locked jaws here and there, but getting the plurality right.

It may not happen that the skills of either of us would often be brought into play, cutting us off in different ways from the charming scene about us, but when you are dealing with something that neither of us has ever seen before, not in bulk, anyway, the situation is profoundly different and likely to fall off the universe for not trying hard enough.

One way of trying extra hard is to imagine one dimension of the universe coated in either black velvet or a blue that no one has reported outside the province of Baffinland. This same needling eye one imagines as bringing reports of blancmange, mince pies, jam tarts, cream pies, chocolate eclairs, Odwalla bars, chocolate chip cookies, ice cream, and all manner of other delicacies to the invalid's bed.

However you spell the word invalid, you are either invalid because not valid, or invalided out. Or you disentangle the least bit of wiry fluff that has been haunting your tongue for half an hour, and assign it to the unwilling project of the human mess. These rank as contributions in some way or other, but the assorted confectioneries are too massive to eat, and the strand of henpecked fluff is too narrow, which makes them both second-rate substitutes and sees them out. What I'm trying to say, in language ever more oblique, is that the human psyche can sometimes see evidence of what is not present to the senses.

"Bosh," one hears you exclaim, "this man is writing about nothing!" But is he? It could be that he is writing about something somebody said to him after he had regained his senses, or that he regained these senses for himself, and detected shreds of rabbit fluff here and there. Imagine a man coming round after five days in the human tank that denatures us all and finds no memory worth talking about. I suspected as much from my 10-day immersion in whatever I was immersed in.

I say this in the most tentative manner because there isn't a great deal of difference between what's roiling and not rolling. You could easily miss it for the whole of the 10-day period. Nonetheless, I think it was there for human consumption, and I am content to identify it--if that is not too canonical a word--as a lump of Lot's wife going nowhere, or what Samuel Beckett, in one of his wilder notions identifies as Arsene going the unerring rounds on his bicycle, even when he has nothing to deliver.

Clearly we are dealing with shadowland at its bleakest, and should not expect too much. It is not likely to reward us with any vision of something discernible. You always have a chance to say "I saw nothing" or "I saw something." And it is not enough to say "I saw Versed or chloroform," because that would generate far too much reportorial weight. To recognize that we are not dealing with much of the known hardly delights anybody, but just imagine how much of the unknown is out there among the dark clusters of stars and the dark matter of which we know nothing. We may think that we are dealing with the nonstop hodgepodge of daily life, but we are also dealing with the opaque mysteries of the universe itself.

Cabbage served twice means death. So says one of the older Greek proverbs, though it goes no further into the lethal lineage of cabbage. I was becoming accustomed to these devil servings, mainly of the mythic cabbage, as distinct from the real one. But how to divest yourself of the mythic...

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